Seán Ó Fearghaíl (Kildare South, Fianna Fail)
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18. To ask the Minister for Defence if he will instigate an independent study into the rate of Lariam-related suicide in the Defence Forces; if he will include in the terms of reference for any such study, that it examines the Health Products Regulatory Authority's adverse drug reaction listing for Lariam, which has found that of all reported reactions to Lariam, over one quarter are related to suicide; and if he will make a statement on the matter. [25089/15]

Simon Coveney (Cork South Central, Fine Gael)
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As the Deputy will be aware, malaria is a very serious disease which kills approximately 1 million people every year in sub-Saharan Africa alone. It is a grave threat to any military force operating in the area.  

In the decade of deployment to sub-Saharan Africa by the Defence Forces, not a single member of the Defence Forces has died from malaria. The anti-malaria regime in place in the Defence Forces, including the use of Lariam, is working.

The Health Products Regulatory Authority, HPRA, formerly the Irish Medicines Board, is the statutory authority with responsibility for the quality, safety and efficacy of medicines in Ireland. The Defence Forces policy on the use of anti-malarial medication is in line with current HPRA approved summary of product characteristics (SmPC).

The Deputy might note that the allegation of a link between Lariam and suicide/ suicide ideation has been examined. Of 156 non-service related deaths among members of the Defence Forces in the period January 2000 to December 2010, 25 were apparently from self-inflicted injuries, although only one is recorded by a coroner as “suicide”. Of these 25 deaths, 16 had never been prescribed Lariam. Of the remaining 9, given the limited period of time during which Lariam remains in the bloodstream, according to our expert advice, it is extremely unlikely that Lariam could have been a contributory factor in practically all of these cases. There is no evidence in any of the coroners’ inquests linking any deaths to Lariam.

The death rate in the Defence Forces from self-inflicted injuries in the period 2000 to 2010, when Lariam was being prescribed, was 0.24%. The death rate from self-inflicted injuries in the period 1989 – to 1999, when Lariam was not being prescribed, was 0.32% which is higher than the death rate in the period when Lariam was being prescribed.

Anti-malarial medications, including Lariam is licensed by the HPRA and must remain in the formulary of medication prescribed by the Medical Corps for Defence Forces personnel on appropriate overseas missions, particularly those in sub-Saharan Africa, to ensure that our military personnel can have effective protection from the very serious risks posed by this highly dangerous disease.